Shazia Farooqui Friday, 19 June 2020

Delhi : The Covid Capital

With a total of 480 government labs and 208 private labs as authorized test centers , India, with its dense and diverse population of 130 million, is struggling to test citizens for COVID-19 as compared to neighboring South Asian countries with a similar population structure.

Despite having conducted around 5 million tests since February as of June 15, India needs to ramp up its testing capacity drastically to tackle the spread of the virus. Currently, the country has a testing rate of a mere 0.08 per 1,000, with a positivity rate of 5 per cent. Note that this data pertains to the number of samples tested, which is more than the number of people tested, since the test may be administered to the same person multiple times.

India’s test positivity rate (TPR), ratio of positive results to total tests, stands at 8.2 per cent, dangerously close to the 10 per cent mark, beyond which the country desperately needs to widen its testing base. ICMR data shows that the test positivity rate has been the lowest in a month, 3.8 per cent. Higher positivity rate indicates faster spread. This number may be reassuring to some, but don’t be fooled by statistics; they often gloss over the bigger picture.

Delhi is currently struggling with a TPR almost five times that of the national average of 3.8 per cent, a shocking 37.82 per cent. This value calls into question the effectiveness of the tests, implying that the tests are being conducted only for those at risk or already showing symptoms.

One would expect testing to be increased to balance the positivity rate, but the opposite has happened. Within a week, from June 3 to June 11, Delhi saw a dip in the number of tests, from 6,450 to 5,001 while the TPR rose from 18.3% to 27.7%. Similar is the case in Maharashtra, with the highest number of confirmed cases in the country, its testing rate declined from 14,497 to 12,764. Gujarat, Madhya Pradesh and Odisha have shown a similar downfall in testing numbers amid rising TPRs.

The situation only seems to be worsening as new data reveals that every second test in Delhi and every fifth test in Maharashtra is yielding positives.

The states, by simple math, seem to have reduced the number of tests conducted as it brings down the positivity rate, but their denial to accept the increase in infections is only furthering its spread. However, India has taken some effective steps; the Indian Council of Medical Research (ICMR) has asked Delhi to start rapid antibody detection test along with the usual RT-PCR tests, which are more specific and sensitive in identifying the infected and hence enabling state governments to narrow down red zone areas and carrying out effective lockdowns in the future. The strategy to use antibody tests in combination with RT-PCR tests is cost-effective and useful in monitoring spread of infection among migrant workers.

Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PM JAY) has enabled free testing in private labs in accordance with ICMR and state guidelines.

In another of the government’s long list of unfulfilled promises, Home minister Amit Shah aims to double testing in the capital by June 20, but it is not enough. At least a 10-fold increase is required to meet the numbers of other countries and curb the spread. As untested, potentially asymptomatic individuals return to work with Unlock 1.0, the states must make effective and widespread testing their priority.